Evaluating The Effect Of CTR On Maintaining The Stability Of The Effective Lens Position After Surgery In Patients With High Myopia Complicated With Cataract By Master 700

Objective:To evaluating the effect of capsular tension ring(CTR)on maintaining the stability of IOL position after cataract surgery in patients with high myopia complicated with cataract by IOLMaster 700.Methods:This trial enrolled 20 patients(40 eyes)with high myopia(Axial Length>26.00mm)complicated with cataract who underwent phacoemulsification and IOL implantation in our hospital from May 2020 to September 2020.Among them,8 were male(40%),12 were female.The mean age was 62±10.79 years(range 50 to 85years).Single-piece hydrophobic acrylic IOL(CT ASPHINA 603P)was implanted for all cases.Each patient had a CTR implanted in one eye and without a CTR implanted in the other eye.Eyes implanted with CTR were divided into the test group(CTR group),eyes without CTR implanted were the control group(non-CTR group).Uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA)and refractive power were compared between the two groups at 1 week,1 month,3months,and 6 months after surgery.Refractive power is the spherical lens value at each follow-up time.IOLMaster 700 performs B-scans during all follow-ups,and the effective lens position(ELP)was measured combined with Image J software.ELP was described as the interval from the posterior surface of the cornea to the anterior surface of the IOL on the visual axis.It indicates the axial position of IOL.The actual axial movement of IOL was defined as the root mean square(RMS)of the change in ELP at each visit.We compared the ELP value and the root mean square of the ELP(ELPRMS)between the two groups at each time point.The relationship between the change of the refractive status and the ELP was analyzed.Results:1.The UCVA and BCVA of the two groups at 1 week,1 month,3 months,and 6months after operation were significantly better than those before the operation,and the differences were statistically significant(all P<0.05).There was no significant difference in UCVA and BCVA at each follow-up time point between the two groups(all P>0.05).Intragroup differences of UCVA and BCVA were not statistically significant(all P>0.05).The CTR group(UCVA: F=0.018,P=0.997;BCVA: F=0.173,P=0.914),non-CTR group(BCVA: F=0.173,P=0.914;BCVA: F=0.576,P=0.632).2.No significant differences were observed between the mean ELP of the two groups(P>0.05).Intragroup differences were not statistically significant(CTR group:F=0.565,P=0.640;non-CTR: F=2.445,P=0.070).The IOL was slightly moved forward from 1 month to 3 months after surgery,and there was no significant movement from 3 months to 6 months in the CTR group.In contrast,the eyes in the non-CTR group exhibited a tendency for backward IOL movement from 1 week to 3months after surgery,and stabilized from 3 months to 6 months.The mean ELPRMS was a significantly smaller for the CTR group than that for the non-CTR group(0.17±0.10 mm vs 0.27±0.22 mm,P<0.05).The CTR group had less axial movement and had better axial stability during the all follow-ups.3.There was no significant difference in refractive power between the two groups at each time point(P>0.05).No significant difference was found in the average refractive power within the groups(CTR group: F=0.021,P=0.996;non-CTR group: F=0.216,P=0.885).In the CTR group,there was a slight myopia after surgery.While,for the non-CTR group,there was a myopia from 1 day to 1 week,a hyperopic shift from 1 week to 6 months after surgery.4.There was a positive correlation between the change of refractive power and the ELP after surgery(r=0.416,P=0.001).Conclusion:1.Phacoemulsification combined with IOL implantation for the treatment of high myopia with cataract can effectively improve vision.However,there was a tendency toward refractive shift after surgery in high myopia eyes.The influence of refractive shift should be considered when estimating postoperative refractive power.2.ELP is obtained indirectly by IOLMaster 700,which has the characteristics of non-invasive,fast and accurate measurement,and high degree of coordination.3.We obtained the changes of the postoperative effective lens position through IOLMaster 700 and observed that the capsular tension ring can reduce the axial movement of the intraocular lens in patients with high myopia complicated with cataract,and further enhances the stability of the effective lens position and the refractive status.